# Decision-Making in Genetic FTD

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $731,351

## Abstract

PROJECT SUMMARY/ABSTRACT
Frontotemporal dementia (FTD) is marked by profound impairments in decision-making; unfortunately, FTD is
typically only diagnosed after patients have made significant errors in judgment. Clinically, delays in diagnosis
reflect the absence of objective clinical tests for decision-making, and are missed opportunities to prevent
serious harms. Scientifically, delayed diagnosis limits our ability to study decision-making deficits, as research
patients with confirmed FTD tend to have more profound deficits that may not reflect early changes, and often
cannot tolerate more sophisticated behavioral paradigms. This clinical and scientific gap will be addressed with
neuroeconomic analyses of decision-making in presymptomatic mutation carriers from familial FTD kindreds in
two large NIH-funded multicenter networks spanning the US and Canada. The central hypothesis is that early
behavioral and physiological changes in FTD mutation carriers will reveal initial signs and mechanisms of
impaired judgment in FTD, potentially also elucidating neural mechanisms of impaired decision-making in other
neuropsychiatric disorders. 110 presymptomatic carriers and 110 noncarrier family members from these
multicenter networks will be recruited for tests of decision-making on a secure web-enabled platform that
enables rapid and flexible data collection from participants across North America. Guided by strong preliminary
data, the central hypothesis will be tested by pursuing three specific aims: 1) Apply neuroeconomic models of
decision-making to define subtle alterations in judgment in presymptomatic bvFTD mutation carriers; 2)
Determine structural and functional (resting-state) MRI predictors of altered decision- making in bvFTD
mutation carriers; and 3) Elucidate neural and physiological mechanisms underlying behavioral change in
mutation carriers. Under the first two aims, the web-enabled platform will assay neuroeconomic parameters
such as loss aversion, framing effects, and interpersonal decision-making; which will then be analyzed in
conjunction with a rich dataset of cognitive and neuroimaging measures already being collected per protocol
across network sites. Under Aim 3, behavioral performance on the web-enabled platform will be used to select
a subset of mutation carriers and noncarriers for more detailed in-person physiological and task-based fMRI
testing. This web-enabled approach is innovative, because while other researchers have begun to use online
methods to administer tasks to large numbers of participants at home, this strategy allows the evaluation of
hypotheses involving neuroimaging and standardized measures that cannot be performed online. This
combines the strengths of traditional on-site evaluation with the flexibility and scaling advantages of newer
online methods. The proposed work will thus make a significant contribution by applying novel methods and
more precise neuroeconomic measures of decision-making in a large samp...

## Key facts

- **NIH application ID:** 9905328
- **Project number:** 5R01AG022983-14
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Winston Chiong
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $731,351
- **Award type:** 5
- **Project period:** 2004-09-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9905328

## Citation

> US National Institutes of Health, RePORTER application 9905328, Decision-Making in Genetic FTD (5R01AG022983-14). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9905328. Licensed CC0.

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